What happens when a company becomes a proverbial fly on the wall in the physician’s exam room as she’s meeting with patients? Real-life insights into what health consumers ask for, and how they converse with doctors — neither of which match up to a pharma marketer’s dream (or business objective) of motivating consumers to ask their physicians to describe specific brands of drugs.

Bloomberg/Business Week published a story online on November 4, 2009, which talks about Verilogue, a company that has recorded thousands of conversations between physicians and patients in different U.S. geographies and across a broad range of medical specialties. What Verilogue found through the linguistic analysis of these dialogues could be a disruptive finding to many health industry consultants and pharmaceutical marketers who have spent hundreds of millions of promotional dollars on direct-to-consumer advertising (DTC) promoting specific brands of prescription drugs. Verilogue found that very few patients actually ask for branded drugs by name, based on what is discussed between patient and doctor in the actual recorded conversations.

In Ask Your Doctor If This Ad Is Right For You, Business Week reports that the most expensive ad campaigns did not yield the greatest number of consumer inquiries for branded drugs from doctors’ prescription pads. The Cymbalta campaign cost Eli Lilly $179 million dollars, but the most successful campaign which prompted the most questions for a specific branded drug was for Boniva — for which Sally Field, the Oscar-winning osteoporotic actress, is spokesperson. That campaign reportedly cost something closer to $80 million — one-half of the Cymbalta DTC budget.

Health Populi’s Hot Points:  The importance of this story is that it’s based on solid evidence — actual conversations between patients and their physicians. Call it evidence-based market research, as opposed to patient or physician recall about what ‘actually’ happened in retrospect. This outcome suggests any of the following, which require further analysis…

Does Sally Field as spokesperson enjoy a “Sister Bertrille” or “Norma Rae” effect, as a trusted celebrity endorser? Certainly, celebrities have been fronting prescription drug ads for well over a decade, from Magic Johnson touting the benefits of  HIV drugs, Bob Dole and Mike Ditka talking earnestly about erectile dysfunction, and Joan Lunden’s endorsement of Claritin in 1988 (possibly the first celebrity-endorsed drug). The point with Field is authenticity: she probably rings true with the target audience of Baby Boomer women.

Do consumers get a form of white-coat syndrome when confronted by their physician? White-coat syndrome is the phenomenon of a patient’s blood pressure reading higher in the physician’s office than it does when taken at home. When a patient doesn’t specifically ask for a prescription drug brand, could they feel intimidated or shy to do so, in effect questioning the authority of the physician? This gets to the question of information asymmetry: as much as health citizens go online to seek health information — and most in the U.S. do so — engaging in actual conversations with doctors about those searches might not be occurring as regularly as some of us have assumed.

What can health marketers do to achieve more effective outcomes with promotional spending?  It’s acknowledged by a growing number of pharma marketers that $multimillion spend on DTC in the traditional modes isn’t sustainable, especially given the current climate of dry pipelines, the patent cliff, industry job layoffs, and tight promotional dollars. Jeff Kozloff, Verilogue’s CEO quoted in the Business Week piece, suggests that arming doctors with useful communications materials and tools can help them address patient concerns about the risks that DTC ads present — which are mandated by FDA regulation of direct-to-consumer advertising.

Think about the simple, powerful act of listening. That’s really what Marketing 101 taught us to do.

Information alone is not enough. Having dug into thousands of patient-physician conversations, Kozloff concludes that, “Even when patients reference outside sources of information during doctor’s visits, they typically do so in a deferential rather than authoritative manner.  Thus, they are rarely impacting conversational flow and physician decision-making.  We need to equip patients with narrative, tools and confidence to actively engage in diagnosis and treatment discussions.”

Disclosure: Verilogue is a client of THINK-Health

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